As OT as you want it to be

High blood pressure, that is. Both for the damage it causes by itself and as a feature of the bigger issue of Metabolic Syndrome…and the financial burden to individuals and health-care systems pretty much Worldwide, I guess)

I got it done this morning (“it” being my extended session of Z2/MAF/ASCVD mitigation training) to my pal Pete’s latest podcast. Can affect almost anyone…whether in spite of being a Good Custodian of your body or as a consequence of the opposite.

This was one of the appalling features of how my mum’s ASCVD manifested itself as a consequence of severe renal artery stenosis and before it had finally been controlled by a really nifty combo of BP meds (one of the earliest uses of ACE inhibitors) she’d already had a stroke.

Apologies if it’s behind a paywall again (oftentimes Attia makes full content and I can never quite fathom which)…

Edit: …and, surprisingly enough, still not on the rap sheet of gifts from my mother. Just for the heck of it…and because it’s something Peter Attia claims to do frequently … measured mine right after I’d done my training sesh and again just now. 145/78 and 114/72 (round about my usual) No explanation for that “normal” BP as it’s without BP meds.


People used to be reluctant to treat high blood pressure because of the side effects of the drugs. But now days they have many choices. You can often treat even very high blood pressure with a combination of low dose drugs with minimal side effects.

High blood pressure is a killer. Its sad that many fail to get treatment. But I suppose after all the miss information on vaccines, nothing should surprise us.

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@VeeEnn you may already have this covered, but in case you don’t…

Increasing potassium intake can help decrease your blood pressure if you have high blood pressure.

I cook with LiteSalt (brand), which is 50% potassium chloride and 50% sodium chloride. Both DH and I have normal blood pressure (< 120/ 75) without taking drugs. I cook all our food fresh. Processed foods often contain high levels of sodium chloride, which is inexpensive. I have never seen potassium chloride on the ingredient list of a processed food.

LiteSalt is much more expensive than regular table salt (100% sodium chloride)…but well worth it.



I’ve been using half sodium chloride and half potassium chloride for a decade or perhaps longer. Mainly to avoid leg cramps. But I recently was diagnosed with high BP and the doc put me on a small dose of medication for it. The doc also asked me to take my BP daily, so I do every morning, and it gets automatically recorded in my Apple health app.

Unfortunately, my BP is still 135-145/80-90 regularly.

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Yes it can…except when the high BP isn’t due to the sodium/potassium imbalance that most Americans consume. If, in fact, it’s due to some other underlying but treatable medical issue, what might be sensible advice in the right circumstances has the potential to delay appropriate diagnosis and treatment. My mum’s renal artery stenosis was the cause of her out of control BP … sometimes spiking as high as 200/135. Although her issues were unrelated to excessive amounts of sodium (not a processed food household whilst I was living at home or since) she tried the various salt free “salts” and ate a banana a day etc. Fortunately, not as an alternative to her ultimately effective cocktail but I think she always hoped/believed it was somehow effective.

As mentioned upstream, years ago I think physicians were much less aggressive with treating high BP…had to be, in fact, as side effects of some of the meds my mum took as recently as the early 1980s were pretty grim. What she ended up doing well with and tolerating pretty well also were actually what would’ve been sub-therapeutic doses of 3 effective meds…a beta blocker, diuretic and ACE inhibitor…that worked synergistically to lower her BP but without the side effects each one could’ve had.

I fortunately don’t appear to have those issues and, although I don’t salt my food heavily, don’t seem to be salt sensitive either. My BP is routinely below the 120/80…sometimes spectacularly so … and even immediately after exercise the systolic has never been much higher than I measured it today.

My husband has also never suffered from high bp but, since his big cardiac reconstruction surgery about 5 years ago, his bp is now kept artificially low…runs around 100-110/70 give or take. Oddest thing is that since he’s been taking a beta blocker and diuretic, he’s incredibly salt sensitive wheras he never was before.

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Losing a lot of my weight has taken my bp down to 130/80 or lower. The doctors took me off a med.

One of my sisters did Noom with me. She tuned in when I began to have success. Her bp had been spiking a lot higher. She lost the 25 she needed to shed. Her bp is very good now. No spiking.

We saved massive medical bills later.


I think that part of the problem is that high BP is generally asymptomatic so taking medication to prevent something that “may” happen in the future …medication sometimes still can make folk feel a little off…doesn’t quite grab the imagination the way it ought. And you know how folk like to portray doctors as being shills for Big Pharma.

High blood pressure as a killer is bad enough but the associated morbidity can arguably be worse (not unlike heart disease, come to that) Kidney disease, stroke, heart failure etc can make ones marginal years not worth living

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Is your doctor aware of this? By today’s standards, this is a bit on the high side. Heck, even 120/80 is the BP equivalent of pre diabetes these days. My mum’s peripheral vascular disease was so bad that, although this BP would’ve been considered high even back in the 1980s, this is where her doctors tried to maintain it because if it dropped much below this, she had a pronounced postural hypotension (sometimes even sitting, let alone standing) hands and feet like blocks of ice. Everything you might imagine with reduced pressure failing to get through blocked “plumbing” and starving end points of blood.

Given my history of reasurrances over my “mildly elevated LDL-C” and belatedly realising that I did, in fact, have an issue that could/should have been addressed I would want a very plausible rationale for leaving my BP at this level


Not yet. I am still keeping the diary for him. I expect to see him in the next month.

My mom also has BP that spikes periodically. Way way way too high. A few months ago, she went to the ER one night because it was so high.

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Phew…that’s a relief. I’ve done an about face over the last 18 months from the person who suggests discussing personal medical issues with ones own physician to taking a cautious approach when reassurances are being given from that quarter.

I recall my husband saying that I must be the only person around who’s actively looking to find fault with their doctor’s suggestion that their bloodwork/self care etc is absolutely fine and they’re in tip top shape…at least, before my CAC scan (which he was confident would be a big fat ZERO!) Singing a different song now, of course.

We’re all somewhat biased towards getting favourable news/diagnoses where our healthcare is concerned, I fancy … especially when there can be a strong correlation between our issues and lifestyle choices in a good many instances. I doubt I’m any different but for the experiences from 40 odd years “at the orifice”. I’ve learned that oftentimes a niggling feeling of doubt was worth the trouble of following up further…I just wish I’d applied that feeling to myself earlier.

Mind you, at the same time, it’s a good idea not to get too phobic about these relatively minor blips on the radar screen in the short term. At least, with your blood pressure, you have a means of objective measurement (I’m amazed at the number of folk who don’t actually measure their own BP fairly routinely) and can follow progress over the longer term.

I remember one patient in residency training that was reluctant to take his BP meds. Why? “It messes with my nature, doc”, i.e., it gave him erectile dysfunction. My retort, you’ll look really sexy when you’re paralyzed on one side, wearing diapers, and being escorted around in a wheel chair. We tried another medication.


Indeed erectile dysfunction is one of the side effects often mention with blood pressure medicines. Some much worse than others.

That is one of the side effects minimized by low doses of multiple drugs rather than massive doses of one or two.

In the PCP office today for something. The nurse took my bp 125/73. No meds.

My weight has dropped 5 lb since allergy season ended June 14th. Some of that is better sleeping habits and diet. I expect another few pounds this coming week, 2 lb water loss, 2 - 3 lbs diet management. I am on track.

The main thing is the calorie intake after dinner. There is nothing wrong with eating before bed. The problem is the number of calories before bed if I let loose. I am tired by then and letting loose is easier. I am managing that well currently.

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